SB2105 SD1.DOC

SECTION 1. According to a 2009 poll conducted for the Closing the Addiction Treatment Gap Initiative, most Americans, regardless of race, age, place of residence, or income, know someone personally who has been addicted to alcohol or drugs. Additionally, the 2009 poll showed that seventy-three per cent of Americans support the idea of including alcohol and drug addiction treatment as part of national health care reform to make the treatment more accessible and affordable. Despite widespread concern and support across America, the legislature finds that treatment for behavioral health disorders continues to be costlier and more difficult to obtain than general medical care. Different financial limits and cost-sharing requirements, limits on coverage, providers, types, and duration of treatment, and other provisions constrain the level and quality of insured health care that is available to those with behavioral health issues.

Pursuant to the United States Department of the Treasury's Interim Final Rules pertaining to the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, group health plans are required to have no more restrictions on mental health and substance abuse disorders than on medical or surgical benefits. The legislature finds that while the Interim Final Rules require action by the State to ensure compliance, the State also has the option to enact and implement parity laws that are even more comprehensive than what is required for federal compliance.

The purpose of this Act is to convene a mental health and substance abuse parity working group to determine how the State can come into compliance with federal mental health and substance abuse parity laws and regulations and enhance its existing parity laws.

SECTION 2. (a) The director of health shall convene a mental health and substance abuse parity working group and may work with any other department to carry out the purpose of this Act. The working group shall consist of fifteen members as follows:

(1) One member selected by the governor;

(2) One member selected by the president of the senate;

(3) One member selected by the speaker of the house of representatives;

(4) One member selected by the attorney general;

(5) One member selected by the insurance commissioner;

(6) One member selected by the alcohol and drug abuse division of the department of health;

(7) One psychiatrist selected by the adult mental health division of the department of health;

(8) One representative of the Hawaii Substance Abuse Coalition;

(9) One representative of the Mental Health Association in Hawaii;

(10) One representative of the Legal Aid Society of Hawaii;

(11) One representative of a health insurance provider, regulated under chapter 431, article 10A; chapter 432, article I; or chapter 432D, Hawaii Revised Statutes, or a managed care provider, such as a health maintenance organization or preferred provider organization;

(12) One medical professional licensed under chapter 453, Hawaii Revised Statutes;

(13) One psychologist licensed under chapter 465, Hawaii Revised Statutes;

(14) One clinical social worker licensed under chapter 467E, Hawaii Revised Statutes; and

(15) One mental health consumer representative.

(b) The duties of the working group shall be as follows:

(1) Review special reports, and updates to the special reports, that provide an analysis of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and relevant Interim Final Rules;

(2) Review the provisions in national health care reform laws and regulations that affect behavioral health care, including:

(A) Provisions that interact with the Mental Health Parity and Addiction Equity Act of 2008; and

(B) Provisions that address the issue of affordability and lack of coordination of behavioral health care through the establishment of federally qualified behavioral health centers and co-location of primary and specialty care services with behavioral health services;

(3) Determine the State's role and responsibilities in implementing the Mental Health Parity and Addiction Equity Act of 2008; and

(4) Based on information reviewed or determined pursuant to paragraphs (1) through (3), examine and make recommendations regarding the addition or enhancement of various components of the State's mental health and substance abuse parity laws, including:

(A) Coverage options, including mandatory coverage of mental illnesses and substance abuse;

(B) Definitions of covered conditions and other terms necessary to implement the State's parity laws;

(D) Financial and durational limits on treatment;

(E) Determination of medical necessity;

(F) Managed care;

(G) Out-of-network coverage;

(H) Adequacy of network provider panels;

(I) Prescription medications;

(J) Specific services for serious mental illness;

(K) Oversight of implementation; and

(L) Independent external review of claims.

(d) The working group shall submit to the legislature a report of its findings and recommendations, including proposed legislation, no later than twenty days prior to the convening of the regular session of 2014 and shall dissolve on June 30, 2014.

SECTION 3. This Act shall take effect upon its approval.

THE SENATE	S.B. NO.	2105
TWENTY-SIXTH LEGISLATURE, 2012		S.D. 1
STATE OF HAWAII